Patient Access Representative

Citizens Medical Center is a not-for-profit hospital known for compassionate patient care, clinical expertise, and bringing advanced medical services to the South Texas region since 1956. Today, Citizens is a 338-bed acute care hospital with over 1,000 dedicated employees.

Citizens offers a generous benefit package that includes retirement plans upon hire, and an excellent medical plan with optional insurance plans to choose from.

If you are interested in pursuing a career with an award-winning hospital, welcome home.

At Citizens Medical Center, the Patient Access Representative position is responsible for obtaining and entering accurate demographic and insurance information in the electronic health record (EHR) on patients presenting at the various entry points of the facility. The Patient Access Representative employs effective communication skills, promoting excellent customer service in every interaction. This position coordinates insurance verification on all admissions to Citizens Medical Center ensuring coverage meets standards of admission and order criteria.

This position is also required to adhere to all departments, hospital, governmental and/or any other healthcare licensing agency requirements related to the Emergency Medical Treatment and Labor Act (EMTALA) and the Health Insurance Portability and Accountability Act (HIPAA).

Job Specific:

• Promotes a positive work environment and contributes to a dynamic team focused work unit that actively helps one another to achieve optimal departmental and organizational results.
• Communicates openly in a non-judgmental manner and in a professional demeanor during all interactions with customers and co-workers.
• Contributes to departmental and hospital patient experience. Proactively seeks solutions to address patient issues and concerns. Alerts management in a timely manner to any unusual and/or difficult situations impacting the level of service.
• Consistently takes the necessary steps to ensure that protected health information remains private and confidential, according to established State and Government Privacy Rule guidelines.
• Organizes time effectively, minimizing incidental overtime and sets priorities. Utilizes time between heavy workloads efficiently and helps other team members.
• Displays initiative to improve job functions. Demonstrates adaptability and flexibility during changing demands. Offers suggestions to streamline process for efficient patient flow.
• Seeks opportunities to expand learning beyond baseline competencies with a focus on continual development.
• Obtains and records accurate demographic and insurance information on patients by interviewing patients, family members and physicians. Ensures that the correct insurance plan codes are utilized for the billing process. (EF)
• Explains the consent forms, obtains signatures on the forms, and responds to any questions in a professional manner. (EF)
• Uses patient identifiers consistently to properly identify patients and the correct medical records. Refrains from issuing new medical record numbers to patients with existing accounts. (EF)
• Meets goals set by the department (e.g., registration error rate, productivity/activities per hour, etc.).
• Ensures that ordered services meet established medical necessity criteria when applicable. (EF)
• Collects payments based on pre-determined information. Performs insurance verification to determine patient out of pocket expenses for services. If applicable, offers payment options after the minimum required payment has been received. (EF)
• Fulfills monthly goals for cash collection. Assures collections attempts are 100% (All patients with a potential balance are approached.)
• Accurately posts and receipts patient payments. Balances cash drawer daily; follows the department policy related to cash drawers and cash receipting. (EF)
• Works on other duties, pulls orders, and pre-registers patients over the phone as required

Registration:

• Knowledgeable regarding specific procedures and tests, as well as insurance requirements.
• Understands pre-authorizations importance, as well as preparations needed for testing.
• Understands the components of a valid order, assures this is…